'A Job' in the UK
We have had a few e-mails from people in India asking about how long it takes to get a job, how hard it is, does it help to be a PG etc....

I post a mail from Dr Alaknanda, to similar effect, with replies from myself and Dr Amit Todani - the message being - clear your perspective about what 'a job' means, and do not set an upper cap to how much you might be expected to spend - because we can't!

Please note: these are our observations - u are the master of your own folly :)

Mail 1: From Dr.Alaknandai just checkd the plab forum and found out that an aspiring plabber must be prepared to spend an additional ~Rs4,00,000 besides the ielts and plab fees for the long period of unemployment that comes as a package with passing the plab test-theres also a 25%better chance of getting a job if the candidate has a PG degree-id really like2 know if its true-i personally know someone whos an orthopod and had a tough time finding a job there and that was 4yrs back is the condition equally pathetic for USMLE aspirants?i know the expenses for the usmle steps 1,2,2cs&3 but id be grateful if i cud get some information about the additional expenditures(that is not available in the ecfmg website)-i just want to have an estimate of the expenses before i embark on anything-and is it required to appear for an exam like ielts for usmle as well?and r the prospects of finding a job in the us as bleak as in the uk?

Reply No 1: Me being the devil's advocate [sort of]

For Alaknanda and others thinking bout UK,

For everyone aspiring to come to uk, I would like to point out a common mistake we make during our research - we focus on 'a job' . it's always 'a job' , even GMC gives it's evidence as time taken to get 'a job'

In reality, 'a job' could be in a subject u have no interest in. It could be a prho [intern] job even though u may be a PG, it could be a honorary job - where u get no pay at all, or a locum for a single day [at rates of 14-18 pounds an hour before taxes] , several friends, including nrsites have been doing intermittent locms that gives them just enough to manage a week at a time, with occassional aid from family and friends. Others have been able to get jobs at gp surgeries collecting data etc [for which you would first need a work permit or dependant visa].

On an average the waiting period to get a job that at least helps u survive the month - is a year . no evidence available, this is ust my subjective experience. in this year , you would be applying for your visa 1 - 3 times [i think bout 400 quids each time? ] you would be living in some accomodation - 50 a week you would be tragvelling, calling people, making a million coies of your cv and then using royal mail to send out parcels the size of your average 'desh' or 'sananda' - [15 copies of your cv if you don't mind]

If you were living in London, a day's travel could cost you from 3.50 to 7 pounds .O and now it is necessary in some jobs to have a valid uk license - the international license is no longer valid. its bout 70 pounds for the two exams, 5 pounds to send your passport to apply for the license, and 20 pounds per lesson - yet to meet someone who did not take at least 10 lessons and passed. - yet to meet someone who passed att he first instance. some jobs insist u have your own car. and i know one unfortunate indain , who lied about it, and although he wassuccesful at the interview, lost the job later when he said he was willing to hire a taxi for every trip he had to make.

I could go on about the list of expenses involved. This is not to scare you, but to give u a better picture of what you are going to face.

Bout PG degrees, i have no clue. I really dont know if it's any easier to get a start, but career progression might be quicker. worst comes to worse, at least you know you can do stuff if u had to return ..

hope that makes some sense.

RegardsSunanda

Answer No 2: From Dr Todani, who is more actively in the job hunting scene:

I agree with sunando. there is no doubt in the authenticity in any of his statements, only he has been a bit `moderate'. The picture is actually a bit worse (actually a lot). may i add that if you really want to be in a decent position to 'apply' for a particular speciality, u need to have completed all the courses IN UK relevant to that job, eg ALS/ATLS for A&E/surgery/medicine (GBP 450 +), microsurgigal skills course for ophthalmology (GBP 500 +) plus parts 1 & 2 of membership examinations (300-400 Quids each). Regarding PG, if you are unfortunate enough to have done a PG back home (except MD in anaesthesia or DA), U would end up sitting on the fence. It would not only restrict your choice of specialities (imagine an ophthalmologist applying for a Gynae job!), but also exclude u from Foundation programmes (yes even most standalone F2s). If u noticed the recent ad for the run-thru grades, those having more than a year's experince at SHO level are automatically filtered out from ST1 pilots. Even the GP jobs would be restricted to those who have completed Foundation Programme in UK from Aug 2007. Regarding locums, u can't do any locums on PLAB visa and u dont get a PFT or work-permit for any locum less than 3 months (and u need to get a Dean's Letter as well stating that your locum is a recognised training post). Each time u go to get a visa stamp, it costs u GBP 500. At the end of it, if u end u getting a substantive job within 1 year, u would be one of the priviledged few as there are thousands of doctors who have either done a few locums or are completely unemployed even after one and a half years. As with everything, there are exceptions. I personally know a girl, who got 3-year GPVTS within 2 months of coming to UK even without doing a Clinical attachment and no experience whatsoever at SHO level.Hope that helps!

Little caution....
'parthasd' recently contributed to the egroup with this mail. it paints a grim but realistic picture of our future in the UK.I usually try not to discourage people, but recently I have had to listen to people who came here with an unrealistic expectation of the future, and now several thousand pounds down the line they can only say that people are getting jobs because they have 'catch'. They scoff at simple suggestions to try their best by saying things like, 'from your position it must be nice to give such advice, but the reality is quite different ....'

Bottom line, don't come here expecting sympathy. You come here to struggle and u shall have to fight till the last penny.

Enough ranting, here's parthasd's view:

I am completely new to this group. I am in the UK for last 7-8years. Don't quite know about the recent changes in the PLAB test.But one thing is certain, things are definitely getting more andmore difficult. And of course there are exceptions.

MMC (modernising medical curriculum) has changed the whole equationin the last 2-3 years. The situation is going to worsen further inthe next two years. Currently it is extremely difficult to get atraining SHO job. [My last SHO (London graduate, white AND a lady)could not find a job from August and headed south (Australia).] Sameis going to be the case with Type 1 SpR (higher specialty training)jobs in two years time once the current foundation trainees will beready for the 'seamless' higher specialty training. What they willbe able to do after becoming a 'junior' consultant is everybody'sguess.

Anyway, the Royal College of Surgeons of Edinburgh took the bold (!)step last week to warn all overseas candidates about planning foran 'exit strategy' or to take up non-training career grade post forthe rest of their lives. They predict that there will be about 500training numbers nationwide for general surgery and 1,500 UKqualified candidate alone aspiring for a career in general surgery.Therefore, only 1 in 3 UK graduate aspiring a surgical career willactually make it through. Although the RCS 'warns' foreigngraduates, I suspect, the much hyped 'equal opportunity' will betactically thrown out of the window.

UK is not going to be the ideal place to invest your time and moneyunless you are not already in the system (by that I mean, you arehere in a training post and having done with all the 'M' exams/research/ publications etc).

Surgical specialties have traditionally been more difficult thanmedical specialties. This is going to be the case for the forseeablefuture.

Sorry to give a gloomy picture but unfortunately this is the realsituation. Hope this helps.

Question bank for interviews?
I have collected a set of questions that are asked at Psychiaitry SHO post interviews. Drop a line if any one is interested.

For those who have already faced interviews:I would appreciate getting more questions , not only for psy, but for other jobs as well. Admit it, answering questions about your weaknesses was not something you were comfortable bout right from the start???

hello there,here r some answers to your queries. 1. All streams r difficult to get into. it depends what u want to do whetheryour CV projects that in the right wat or not.2. now-a-days it is probably best to look for Foundation Year jobs, which have become compulsory for UK graduates. Application forms are deanerybased for the Foundation programme. Some deanery have quite a few jobs leftafter allocating to local graduates. Mersey Deanery gave out 60 jobs to overseas graduates last year and this year as well. That is where i got my House job(PRHO) last year and subsequently F2( first year SHO) this year.useful websites. www.mmc.nhs.uk http://www.merseydeanery.ac.uk/main.asp3. My personal opinion is that to come to UK as early as possible till this Foundation posts lasts. Mersey Deanery has already increased theirmedical school intake from 2001-02. So these guys will graduate by 2007 and no jobs will remain at least in the Foundation Programme for us.4. ATLS/BLS in India is not recgnised by Resuscitation Council, UK. So youhave to do these in the UK. But u can do these in India becoz good for CV.ATLS is a requisition for MRCS .5. Internship is equivalent to PRHO in this country. So it is not recognised for MRCP/MRCS. Clearing MRCP1 is good becoz you get points for shortlisting from your CV>part1 is reallly good for that.Once you have completed Mrcp2 , u have to do PACES within 2 years, otheerwise part2 is null and void. 6. on visitors visa , it is illegal to work. SO donot even think about it.7. Once you have cleared Plab1, start applying for attachments from India itself. some of my classmates wre lucky to get attachments from INdia itselfbecoz they did that.Okay bye for now, has go go for my night shift.TathaP.S.- some views expressed above r my own as I have experienced in the last17 months in UK.ci

Foundation Course, How it affects us, and the 5 points for shortlisitng
Dr Naved Ahmed adds:

hi,Sunando you have given a good picture of the state ofaffairs..let me make it look a bit "better"...thisyoung lady who is writing everyday is definitely doinga good thing, trying to know the situation...one thingwhich i don't think many of us did....well yourqueries are quite legible...i will try and answer themfrom MEDICINE point of view only:

1. Doing an MRCPI from India is definitelyhelpful...it will give you probably a 25% betterchance of getting your job but then again,"nothing issure"(remember these 3 words forever when in UK)2. Things have changed with the introduction of MMC,most of the jobs have been converted to foundationyear posts and people having an MD from Home will notget these jobs. Due to the introduction of these jobsSHO roatations are going to b a thing of the past.Check out this link...http://careerfocus.bmjjournals.com/cgi/content/full/331/7514/90?eaf3. Most hospitals are now adhering to a strict scoringsystem for short listing and the five main criteriafor short listing are: UK experience, MRCPI, Audits,ALS/ALERT course and case and paper presentations. SOif you can work at these you will get a job but thenagain remeber those"3 words".4. Last but not the least UK graduates are going toNew Zealand as there are not enough jobs here...therewere 2000 jobless UK graduates this August.

I hope this will give you further look into thematters here..do keep writing if u want 2 knowmore...all the best.

More about ALS,BLS,ATLS and other coursesMood: energetic
Thanks to Dr Nirjhar Nandi for this one:

"Hi

Sunanda has presented an excellent overview on PlAB and getting first job in UK. Here is few more...

-Things are changing in uk. Foundation programmes are coming up replacing regular SHO posts in a particular speciality. Two parts - F1 & F2. F1 is equivalent to PRHO and F2 is SHO. Regarding Foundation programme, THE EARLIER U COME (AFTER YOUR MBBS), THE MORE IS UR PROBABILITY TO GET INTO IT. Still it is difficult. Ur CV must show something to differentiate u from others.

- Regarding BLS/ALS/ATLS courses in UK:

BLS : One can do it at any UK NHS hospital by paying ?15 - ?25 on an average. Employees/Clinical Attachees may be exempted from paying. Getting a Place is not difficult.

ALS: Find the course centre and available dates at http://www.resus.org.uk/pages/alscours.pdfYou can call or mail directly to the course coordinators of individual centres to get an aplication form. Most of the centres give priority to the applicants according to your grade,speciality and region. Others do it on first come first serve basis. Getting a place is difficult. Aerage waiting time is 4-5 months. It costs around ?300 - ?400. Highly demanding course. Specially designed for Medicine, A&E, Intensive Care and Anaesthesia.

ATLS: Most demanding course for A&E, General Surgery, Trauma & Orthopedics and to some extent Anaesthesia. Find ur centre and availability at http://www.rcseng.ac.uk/education/docs/ATLS%20Course%20List.pdf . Very Very difficult to get a place. Candidates are mostly selected by shortlistig according to grade, speciality and region. Average waiting time is 10 months. cost is ?450 - ?600.

Other couses like EPLS & ALERT are also helpful.

Doing all the courses and MRCP-1/MRCP-1 u may still find it hard to get ur job. But certainly they will give some advantages over others.

But I personally believe the most important thing is what 'luck' are you bringing with u to UK.

Firstly, every one has a different experience about PLAB and UK. There is no hard and fast rule. So while you are taking info, don't base your decisions on exceptions. Rather base it after considering the average, if not the worst. The info I provide basically comes from feedback from east ham docs, and those who got jobs in the last 5 months.

PLAB2 has changed a bit. While people become anxious about the 'new' 'first time' osces, most fail on the good old osces that we used to do even in 2003. It's all about practising and getting stock replies into your head, which will work even when you are actually working on the wards.

Luck is undeniably a factor, but luck does favour u when u are prepared for it. Getting jobs mean a lot of things, including the possibility of a job cropping up where u are doing an attachment. Those who get jobs without an attachment have really unusual luck :)

The deal here is to improve the odds of getting a job. For that:

- MRCP1 / MRCS1 etc is a recommendation - yes. MRCPsych is not possible because u need to have worked here for a year at least b4 u r eligible.

- Build your cv - recently i know one doc who got a paeds sho post, 2 months after coming to this country - her cv had research [from the private paeds hospital at park street- forget the name] and audit from another private hosp.

-do a BLS / ATLS course in india, it costs bout 800 rs, there are institutes in pune, find out which ones. Apollo delhi also does few 'online' courses that are expensive, don't mean nething to the nhs, but at least make ur cv better than the rest. Even if u dont do those, when u come to uk, try and get a 'bls' and an 'atls' course. again it's optional, i haven't met many in the last two years who did not have to do one before they got a job. Most hospitals will make you pay for the courses. Prices vary from 350 to 500 pounds each.

-cut short the waiting time - whatever work u do in India should reflect on your long term interest. doing a hs in dermae or eye and asking for a job in hand o wont look good. as soon as u know when u are coming over for ur plab 2, start applying for attachments.

-make ur cv and keep updating it. what seems good to u today will seem like crap in a months time..

-PG- from my point of view, pg graduates have an edge when it comes to passing exams, doing staff grade posts, and even getting the first jobs, but consultants who are in the shortlisting process can answer that better. I think it comes to a point where the consultants decide on the basis of their personal experiences - no one likes obnoxious rigid pgs, who might argue with u :) , then again, some would prefer having an sho who wont call u up for every little thing.

whether you will succeed or not.tough!when i came to uk, the rule was we will succeed, but we don't know how long it will take and how much it will cost. people living here without a job for over a year was not unheard of even then. The problem now is that the costs have increased, and the visa has become a pain.

-one of my friends from nrs has agreed to mail some info to the group bout doing atls courses here, another might give us info bout the indian courses etc.

Costs?
Q:hi, presently m doin intrnship whch is gng to get ovr in june.im preparing for plab bt i kno th current situatn in uk or london is nt favorabl for jobs...bt i wish to giv mrcp/mrcs,moreovr i heard systems of plab r changing. it wil b of grt help to me if som1 enlightns me regardin abov-hw shud i proceed &al &th expenditure etc

A:Have you appeared for IELTS yet? If you are determined to make the move, do consider giving the ielts before you start planning. That's not because we doubt your ability to pass IELTS, but because that will give u an idea of the time frame required for you to appear for plab2. Things are changing quite rapidly nowadays.

The rules were supposed to be changed in August, but there hasnt been ne changes in the rules for PLAB.

While the PLAB structure hasn't changed much, all the collaterals have. What has become difficult is - extending your visa once you are in the country. Getting attachments, jobs etc...Off late, most plab candidates have to renew their visa 2 to 3 times before they get their first job, each time it costs u bout 500 pounds. All other costs have gone up over the last few months. Some places now insist you pay the hospital to do an attachment, and getting an attachment could take form 1 to 4 months. Some of us want to compile a list of the possible expenses etc, we will put it up on the site if and when we are done, but the rule of thumb it that u should at be prepared to give plab2 twice, and extend your visa 2 times, not to mention other costs.

NB: HOPEFULLY A LIST BASED ON THE EXPERIENCES OF RECENT PLABBERS WILL BE UP ON THIS BLOG BY MID OCTOBER 2005

Priorities
I am not sure where to start from. i could simply start from ielts, but it would be better if i started on a need to know basis, in other words my entries will be based on specific queries. so i know i am not wasting my time hoping for someone to benifit from these pages...besides there never is any guarantee that my suggestions / information shall be of any help, because the first thing i learnt is that every person has an individual experiencethat is similar to but different from that of the other person.